Individual
KIMBERLY ANNE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
95 W MAIN ST, CHESTER, NJ 07930-2487
(908) 879-7067
Mailing address
35 WEHRLI RD, LONG VALLEY, NJ 07853-3418
(908) 510-4522
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00249900
NJ
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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